Personality Disorders Flashcards
Why are personality disorders so problematic?
Diagnosis is controversial. Inter-rater reliability is good, test-retest is bad. Lots of overlap between personality disorders and comorbidity. Etiology is poorly understood
What is the DSM definition of personality disorders?
An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture, is pervasive and inflexible, has an onset in adolescence and early adulthood, is stable overtime and leads to distress and impairment
What are the cluster A personality disorders also known as?
Odd/Eccentric
Who do personality disorders distress the most?
Other people
What 3 disorders make up the Cluster A personality disorders?
Schizoid, Schizotypal, Paranoid
What is characteristic of schizoid personality disorder?
Extreme isolation, inability to enjoy social relations
What is characteristic of schizotypal personality disorder?
Social awkwardness, bizarre thoughts and behaviour
What is characteristic of paranoid personality disorder?
Suspiciousness, hostility, lack of trust in relationships
What are the Cluster B personality disorders also known as?
Dramatic/emotional/erratic
What 3 disorders make up Cluster B?
Histrionic, Narcissistic, Antisocial, Borderline
What is characteristic of histrionic personality disorder?
Flamboyant but superficial style, self-centredness
What is characteristic of narcissistic personality disorder?
Grandiosity, lack of empathy, need for admiration
What is characteristic of antisocial personality disorder?
Cruel and aggressive behaviour, disregard for rights
What is characteristic of borderline personality disorder?
Emotional instability, fear of abandonment
What are the Cluster C personality disorders also known as?
Anxious/fearful
What 3 disorders make up the Cluster C personality disorders?
Dependent, Avoidant, Obsessive-compulsive
What is characteristic of dependent personality disorder?
Submissive and passive style, need to be taken care of
What is characteristic of avoidant personality disorder?
Social withdrawal out of fear of criticism or inadequacy
What is characteristic of obsessive-compulsive personality disorder?
Rigid adherence to rules and details, desire for perfection that outweighs human rights
What are some important characteristics of personality disorders?
Longstanding and pervasive Causes social distress to others Ego-syntonic Later leads to personal distress Culturally dependent
What does it mean by personality disorders are ego-syntonic?
The person is quite fine with how they are. The problem isn’t them, it’s you.
How are personality disorders culturally dependent?
Some cultures value the traits that come with personality disorders. Ex: Ability to fight, defend family and possessions without empathy towards others, survival tactic in some cultures.
What is Criterion A in the diagnosis of Personality disorders?
Pattern of behaviour must manifest in two of the following: Cognition, emotions, interpersonal functioning, impulse control
What is Criterion B in the diagnosis of personality disorders?
Enduring pattern of behaviour that is rigid and consistent across a broad range of situations
What is Criterion C in the diagnosis of personality disorders?
Behaviour should lead to clinically significant distress
What is Criterion D in the diagnosis of personality disorders?
Stability and long duration of symptoms with onset in adolescence or earlier
What is criterion E in the diagnosis of personality disorders?
Behaviour cannot be accounted for by another disorder
What is Criterion F in the diagnosis of personality disorders?
The behaviour is not attributed to the effects of a substance or medication, or to a general medical condition
What will clinicians have to do if the DSM moves to a hybrid dimensional categorical model of assesment for personality disorders?
Will need to assess for pathological personality traits associated with one (possibly more) personality disorders in order to produce a diagnosis
Which four disorders does the hybrid dimensional model propose should be abolished?
Schizoid, histrionic, paranoid, dependent
Why is the diagnosis of personality disorders so difficult?
- Mental health professionals are unfamiliar with criteria or don’t take time to see if patients do meet criteria
- Comorbidity with other clinical disorders that overlap with each other, especially in the same cluster
- Being diagnosed with one PD means another one as well
Which cluster of disorders has a high chance of being diagnosed with a second personality disorder?
Cluster B
What is attachment theory?
Poor attachment leads to ambivalence, fear, avoidance, and other deficits in intimate relationships. The parent-child bond is a template for later relationships
Which celebrity has BPD?
Angelina Jolie
Which celebrity has been supposed to have OCPD?
Steve Jobs. Was incredibly difficult to work with, but also incredibly creative because of it
What is the cognitive behavioural perspective on personality disorders?
Schemas develop early in life and become rigid. Rigid, distorted schemas become familiar and comfortable. Invalidation of childs emotional experiences and simplistic problem solving. Parents model antisocial or inappropriate behaviour, child discipline is aggressive and non-contingent
What does it mean by child discipline is non-contingent?
Discipline is not clearly related to the childs behaviour. If a child fights, not disciplined. If he spills a class of milk, is berated.
What disorder is associated with fronto-temporal dysfunctions?
Schizotypal
What disorder is fronto-limbic dysfunction related to?
Borderline Personality Disorder
Which cluster of disorders has the highest heritability factor?
Cluster B
What is the heritability coefficient for personality disorders?
.75
What is the lifetime prevalence of personality disorders?
6-9%
Which three disorders have the highest prevalence rates?
Antisocial, schizotypal, histrionic
Which disorder has the lowest prevalence rate?
Narcissistic
Which population has the highest prevalence for personality disorders?
Prison populations (70%)
What percentage of people with personality disorders seek treatment? Which cluster seeks it the most?
39%. Cluster B seeks the most (49.1%)
Which populations are more at risk for each cluster?
Cluster A: Men who have never married
Cluster B: Young, poorly educated men
Cluster C: People who finished high school but never married
Which personality disorders are more commonly diagnosed in women?
Avoidant, dependent, borderline
Which personality disorder is more commonly diagnosed in men?
Antisocial
What is the diagnostic criteria for antisocial personality disorder?
A pervasive pattern of disregard for and the violation of rights of others that begins in childhood or adolescence and continues till adulthood. Requires a history of conduct disorder before age 15
What are some things included in the violation of the rights of others?
Nonconformity, callousness, deceitfulness, irresponsibility, impulsivity, aggressiveness, recklessness.
Why does ASPD happen?
Diathesis-stress conditions; genetic propositions combine with social enviromental influences. Men with ASPD have a history of abuse and non-contingent punishment, that makes them indifferent to to punishment
What types of punishment do men with ASPD still shows sensitivity to?
Involves losing money or valued privileges.
What is characteristic of a psychopath?
Not feeling any “real” emotion or recognize emotions in others. Uncanny ability to detect vulnerability. Not necessarily violent (but when they are, commit a bunch of cold-blooded crimes and many enjoy doing so),
What is fundamental psychopathy and secondary psychopathy?
Fundamental: Heavily based on biology
Secondary: Results primarily from severe negative experiences in childhood
Is treatment effective for personality disorders?
Not really
Which cluster of personality disorders is often court mandated?
Cluster B
What is dialectic behaviour therapy and which personality disorder has it proved effective for?
Group treatment that includes social skills building, empathy training, behaviour therapy approaches, emotional management, vocational training
Which comorbid conditions tend to do better/worse with treatment?
Better: depression and anxiety
Worse: Substance abuse disorders
